Diarrhea, Age 12 and Older

Topic Overview

Diarrhea occurs when there is
an increase in the number of bowel movements or bowel movements are more watery
and loose than normal. When the intestines push stools through the bowel before
the water in the stool can be reabsorbed, diarrhea occurs. It can also occur
when inflammation of the bowel lining causes excess fluid to leak into the
stool. Abdominal cramps, nausea, vomiting, or a fever may occur along with the
diarrhea.

Diarrhea is one of the most commonly occurring health
problems affecting all ages. Most adults will have 4 episodes of diarrhea each
year. Diarrhea that comes on suddenly may last up to 14 days.

Diarrhea has many causes.

Diarrhea is often caused by stomach flu (gastroenteritis) or
food poisoning. Diarrhea is your body's way of quickly
clearing viruses, bacteria, or toxins from the digestive tract. Since most
cases of diarrhea are viral, they will clear up in a few days with good home
treatment.
E. coli is a common bacteria that causes diarrhea.
E. coli infection is related to improper food
preparation.

Drinking
untreated water or unpasteurized dairy products can
cause viral, bacterial, or parasitic infections, such as
Giardia lamblia. Giardia lamblia parasite can cause diarrhea that develops 1 to 4 weeks later.
These infections can also occur when you use untreated water to brush your
teeth, wash your dishes or vegetables, or make ice for drinks.

Antibiotics may cause mild diarrhea that
usually clears up without treatment. A more serious type of diarrhea caused by
the bacteria Clostridium difficile (sometimes called
C-diff) may occur while taking an antibiotic or shortly after finishing the
antibiotic.

Laxatives, such as Correctol, Dulcolax, Ex-Lax, or
Feen-a-Mint, may cause diarrhea.

Using too much of products that contain sorbitol
(such as chewing gum) or fructose can cause diarrhea.

Diarrhea may develop after stomach, bowel, or gallbladder
surgery, or after bariatric surgery for
obesity.

Many times the exact cause of diarrhea is hard to
determine. Almost everyone has an occasional bout of diarrhea. Although
diarrhea is annoying, most cases are not serious and will clear up with home
treatment.

Blood in the stool can come from
anywhere in the digestive tract, such as the stomach or intestines. Depending
on where the blood is coming from and how fast it is moving, it may be bright
red, reddish brown, or black like tar.

A little bit of bright red
blood on the stool or on the toilet paper is often caused by mild irritation of
the rectum. For example, this can happen if you have to strain hard to pass a
stool or if you have a hemorrhoid.

Certain medicines and foods can affect the color of stool. Diarrhea
medicines (such as Pepto-Bismol) and iron tablets can make the stool black.
Eating lots of beets may turn the stool red. Eating foods with black or dark
blue food coloring can turn the stool black.

If you take a medicine that affects the blood's ability to clot, such as aspirin, warfarin (Coumadin), enoxaparin (Lovenox), or clopidogrel (Plavix), it can cause some blood in your stools. If you take a blood thinner and have ongoing blood in your stools, call your doctor to discuss your symptoms.

An illness plan for people with diabetes usually covers things like:

How often to test blood sugar and what the target
range is.

Whether and how to adjust the dose and timing of insulin
or other diabetes medicines.

What to do if you have trouble keeping
food or fluids down.

When to call your doctor.

The plan is designed to help keep your diabetes in control even
though you are sick. When you have diabetes, even a minor illness can cause
problems.

It is easy for your diabetes to become out of control when
you are sick. Because of an illness:

Your blood sugar may be too high or too
low.

You may not be able take your diabetes medicine (if you are
vomiting or having trouble keeping food or fluids down).

You may
not know how to adjust the timing or dose of your diabetes
medicine.

You may not be eating enough or drinking enough
fluids.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

Call your doctor now to discuss the symptoms and
arrange for care.

If you cannot reach your doctor or you don't have
one, seek care in the next hour.

You do not need to call an
ambulance unless:

You cannot travel safely either by driving
yourself or by having someone else drive you.

You are in an area
where heavy traffic or other problems may slow you down.

Seek Care Today

Based on your answers, you may need care soon. The
problem probably will not get better without medical care.

Call your doctor today to discuss the symptoms
and arrange for care.

If you cannot reach your doctor or you don't
have one, seek care today.

Home Treatment

Home treatment can help you treat
your diarrhea and avoid other related problems, such as
dehydration.

Take frequent, small sips of water or a
rehydration drink and small bites of salty crackers.

Try to increase your fluid intake to at least
1 qt (1 L) per hour for 1 to 2
hours, or longer if you keep having large amounts of diarrhea. Note: If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.

Begin eating mild foods the next day or sooner,
depending on how you feel.

Avoid spicy foods, fruits, alcohol, and
caffeine until 48 hours after all symptoms have disappeared.

Avoid
chewing gum that contains sorbitol.

Avoid
milk for 3 days after symptoms disappear.
You can eat cheese or yogurt with probiotics.

Nonprescription medicines for diarrhea

If you are
pregnant, talk with your doctor before taking any medicines for
diarrhea.

Nonprescription medicines may be helpful in treating your
diarrhea. Follow these tips when taking a nonprescription medicine for
diarrhea:

Use nonprescription antidiarrheal medicine if
you have diarrhea for longer than 6 hours. Do not use nonprescription
antidiarrheal medicines if you have bloody diarrhea, a high fever, or other
signs of serious illness.

Read and follow
all label directions on the nonprescription medicine bottle or box. Be sure to
take the recommended dose.

Long-term use of nonprescription
antidiarrheal medicine is not recommended. To avoid constipation, stop taking
antidiarrheal medicines as soon as stools thicken.

If your child or
teen gets
chickenpox or
flu, do not treat the symptoms with over-the-counter
medicines that contain bismuth subsalicylate (such as Pepto-Bismol and
Kaopectate). Subsalicylate has been linked to
Reye syndrome, a rare but serious illness. If your
child has taken this kind of medicine and he or she has changes in behavior
with nausea and vomiting, call your doctor. These symptoms could be an early
sign of Reye syndrome.

There are several types of antidiarrheal medicines: those
that absorb water and thicken the stool, and those that slow intestinal
spasms.

Thickening mixtures (such as psyllium) absorb water. This helps bulk up the stool and make it more firm.

Probiotics, such as Lactobacillus, are available in either pills or powder. This
bacteria occurs naturally in the intestine and may help with digestion. When
diarrhea is present, the number of these bacteria is reduced.

General tips

Learn how to clean up diarrhea safely. Protect your hands with gloves while cleaning up. Wash your hands after you are done cleaning up.

Prevention

Food poisoning
is a common cause of diarrhea in children and adults. Most cases of food
poisoning may be prevented by taking a few precautions when preparing and
storing food at home. Perishable foods, such as eggs, meats, poultry, fish,
shellfish, milk, and milk products, should be treated with extra care. Also,
precautions should be taken if you are pregnant, have an
impaired immune system or a chronic illness, or are preparing foods for other high-risk groups, such as young children or older
adults.

The U.S. Department of
Agriculture (USDA) recommends the following steps to prevent food poisoning:

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